DİYABETİK RETİNOPATİ HASTALARINDA PANRETİNAL FOTOKOAGULASYONUN MAKULA, KOROİD VE PERİPAPİLLER ALAN ÜZERİNE ETKİLERİNİN İNCELENMESİ

Öz

Amaç: Bu çalışmada, şiddetli non-proliferatif diyabetik retinopati (NPDR) ve proliferatif diyabetik retinopati (PDR) hastalarında panretinal fotokoagülasyonun (PRP) makula, koroid ve peripapiller alan üzerine etkisinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmamız PRP uygulanan, NPDR ve PDR'li 27 hastanın incelendiği prospektif kohort çalışmasıdır. Early Treatment Diabetic Retinopathy Study protokolüne uygun olarak PRP endikasyonu konulan 27 hastaya, 577 nm dalga boyu kullanan patern lazer cihazı ile PRP işlemi uygulanmıştır. Merkezi makula kalınlığı (MMK), subfoveal koroid kalınlığı (SKK) ve retina sinir lifi tabakası (RSLT) kalınlıkları, lazer tedavisinden önce ve tedaviden 1 ve 3 ay sonra optik koherans tomografi ile ölçülüp kayıt edilmiştir. Bulgular: Diyabetik retinopatisi olan 27 hastaya 577 nm dalga boyunda patern desende PRP uygulanmıştır. PRP sonrası 1.ayda MMK ve RSLT kalınlıklarında istatistiksel olarak anlamlı olmayan bir artış olduğu görülmüşken, bu artış 3. ayda başlangıç kalınlık seviyelerine gerilemiştir (p<0.05). SKK, başlangıç değerlerine kıyasla PRP sonrası 1. ayda ve 3. ayda önemli ölçüde artmıştır (p>0.05). Sonuç: Retinada proliferatif değişikliklerin başladığı diyabet hastalarında tedavinin en önemli adımlarından olan retina fotokoagülasyonunun, retina ve koroid üzerine kısa vadede bazı yapısal değişiklikler yaptığı bilinmeli ve hasta takibinde göz önünde bulundurulmalıdır.

Anahtar Kelimeler

• Diyabetik retinopati
• fotokoagülasyon
• makula lütea
• koroid
• retina sinir lifi tabakası.

Destekleyen Kurum

Kırıkkale Üniversitesi Bilimsel Araştırma Projesi yönlendirilmiş proje kapsamında hazırlanmıştır.

Proje Numarası

2023/057

Etik Beyan

Etik kurul onayı alınmıştır.

Investigation of the Effects of Panretinal Photocoagulation on Macula, Choroid and Peripapillary Area in Patients with Diabetic Retinopathy

Öz

Objective: The aim of this study was to evaluate the effect of panretinal photocoagulation (PRP) on macula, choroid and peripapillary area in patients with severe non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Material and Methods: This is a prospective longitudinal cohort study of 27 patients with NPDR and PDR who underwent PRP. PRP procedure was performed in 27 patients with PRP indication according to the Early Treatment Diabetic Retinopathy Study protocol using a pattern laser device with a wavelength of 577 nm. Central macular thickness (CMT), subfoveal choroidal thickness (SCT) and retinal nerve fiber layer (RNFL) thickness were measured by optical coherence tomography before and 1 and 3 months after laser treatment. Results: Twenty-seven patients with diabetic retinopathy underwent PRP treatment with a 577 nm wavelength in a pattern design. While there was a statistically insignificant increase in MMK and RSLT thicknesses at 1 month post-PRP, these returned to baseline thickness levels at 3 months (p<0.05). SKK significantly increased at 1 month and 3 months post-PRP compared to baseline values (p>0.05). Conclusion: Retinal photocoagulation, which is one of the most important steps in the treatment of diabetic patients with retinal proliferative changes, should be known to cause some structural changes in the retina and choroid in the short term and should be considered in patient follow-up.

Anahtar Kelimeler

• Diabetic retinopathy
• photocoagulation
• macula lutea
• choroid
• retinal nerve fiber layer.

Proje Numarası

2023/057

Kaynakça

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